1887

Chapter 19 : Bloodstream Infections

MyBook is a cheap paperback edition of the original book and will be sold at uniform, low price.

Ebook: Choose a downloadable PDF or ePub file. Chapter is a downloadable PDF file. File must be downloaded within 48 hours of purchase

Buy this Chapter
Digital (?) $15.00

Preview this chapter:
Zoom in
Zoomout

Bloodstream Infections, Page 1 of 2

| /docserver/preview/fulltext/10.1128/9781555815455/9781555813970_Chap19-1.gif /docserver/preview/fulltext/10.1128/9781555815455/9781555813970_Chap19-2.gif

Abstract:

The spectrum of microorganisms causing bacteremia and fungemia in immunocompromised hosts has changed over the last decade, owing in large part to widespread use of chemoprophylaxis, differences in immunosuppressive regimens, and significant increases in the use of long-term indwelling devices. This chapter discusses the approach to immunocompromised patients with suspected bacteremia and fungemia, with particular emphasis on culture-independent diagnostic methods. The authors briefly address the predilection of specific microorganisms to cause invasive bloodstream infections among certain immunocompromised populations and discuss individual risk factors associated with the development of bacteremia and fungemia. The culturing of blood from patients with suspected bloodstream infections has remained one of the most important diagnostic tests performed by the microbiology laboratory. Over the last several decades, improvements in blood culture media and continuously monitoring blood culture systems have greatly enhanced the diagnostic value of blood cultures for the detection of bacteremia and candidemia. The sensitivity of blood cultures is excellent for the detection of nonfastidious bacterial pathogens and increases with the volume of blood collected. Laboratorians can continue to optimize the use of blood cultures for the diagnosis of bloodstream infections and to encourage their clinicians to obtain at least two sets of blood cultures by separate venipuncture before starting antimicrobial therapy.

Citation: Petti C, Hassan H, Reller L. 2009. Bloodstream Infections, p 409-417. In Hayden R, Carroll K, Tang Y, Wolk D (ed), Diagnostic Microbiology of the Immunocompromised Host. ASM Press, Washington, DC. doi: 10.1128/9781555815455.ch19

Key Concept Ranking

Nucleic Acid Amplification Techniques
0.43282208
0.43282208
Highlighted Text: Show | Hide
Loading full text...

Full text loading...

References

/content/book/10.1128/9781555815455.ch19
1. Alexander, B. D.,, E. D. Ashley,, L. B. Reller, and, S. D. Reed. 2006. Cost savings with implementation of PNA FISH testing for identification of Candida albicans in blood cultures. Diagn. Microbiol. Infect. Dis. 54:277282.
2. Archibald, L. K.,, L. C. McDonald,, S. Rheanpumikankit,, S. Tansuphaswakikul,, A. Chaovanich,, B. Eampokalap,, S. N. Banerjee,, L. B. Reller, and, W. R. Jarvis. 1999. Fever and human immunodeficiency virus infection as sentinels for emerging mycobacterial and fungal bloodstream infections in hospitalized patients >15 years old, Bangkok. J. Infect. Dis. 180:8792.
3. Aronson, M. D.,, and D. H. Bor. 1987. Blood cultures. Ann. Intern. Med. 106:246253.
4. Blumberg, H. M.,, W. R. Jarvis,, J. M. Soucie,, J. E. Edwards,, J. E. Patterson, et al. 2001. Risk factors for candidal bloodstream infections in surgical intensive care unit patients: the NEMIS prospective multicenter study. Clin. Infect. Dis. 33:177186.
5. Boutati, E. I.,, E. Anaissie, and, J. Fusarium. 1997. A significant emerging pathogen in patients with hematologic malignancy: ten years’ experience at a cancer center and implications for management. Blood 90:9991008.
6. Bryant, J. K.,, and C. L. Strand. 1987. Reliability of blood cultures collected from intravascular catheter versus venipuncture. Am. J. Clin. Pathol. 88:113116.
7. Carratala, J.,, F. Alcaide,, A. Fernandez-Sevilla,, X. Corbella,, J. Linares, and, F. Gudiol. 1995. Bacteremia due to viridans streptococci that are highly resistant to penicillin: increase among neutropenic patients with cancer. Clin. Infect. Dis. 20:11691173.
8. Carratala, J.,, F. Sevilla,, F. Tubau,, M. A. Dominguez, and, F. Gudiol. 1996. Emergence of fluoroquinolone-resistant Escherichia coli in fecal flora of cancer patients receiving norfloxacin prophylaxis. Antimicrob. Agents Chemother. 40:503505.
9. Clinical and Laboratory Standards Institute. 2007. Performance standards for antimicrobial susceptibility testing; 17th informational supplement (M100-S17). Clinical and Laboratory Standards Institute, Wayne, PA.
10. Clinical and Laboratory Standards Institute. 2007. Principles and procedures for blood cultures; proposed guideline (M47-P). Clinical and Laboratory Standards Institute, Wayne, PA.
11. Cockerill, F. R.,, J. W. Wilson,, E. A. Vetter,, K. M. Goodman,, C. A. Torgerson,, W. S. Harmsen,, C. D. Schleck,, D. M. Ilstrup,, J. A. Washington, and, W. R. Wilson. 2004. Optimal testing parameters for blood cultures. Clin. Infect. Dis. 38:17241730.
12. Corless, C. E.,, M. Guiver,, R. Borrow, et al. 2000. Contamination and sensitivity issues with a real-time universal 16S rRNA PCR. J. Clin. Microbiol. 38:17471752.
13. Crump, J. A.,, D. C. Tanner,, S. Mirrett,, C. M. McKnight, and, L. B. Reller. 2003. Controlled comparison of BACTEC 13A, MYCO/F LYTIC, BacT/ALERT MB, and ISOLATOR 10 systems for detection of mycobacteremia. J. Clin. Microbiol. 41:19871990.
14. De Groote, M. A.,, and G. Huitt. 2006. Infections due to rapidly growing mycobacteria. Clin. Infect. Dis. 42:17561763.
15. DesJardin, J. A.,, M. E. Falagas,, R. Ruthazer,, J. Griffith,, D. Wawrose,, D. Schenkein,, K. Miller, and, D. R. Snydman. 1999. Clinical utility of blood cultures drawn from indwelling central venous catheters in hospitalized patients with cancer. Ann. Intern. Med. 131:641647.
16. Doucette, K.,, and J. A. Fishman. 2004. Nontuberculous mycobacterial infection in hematopoietic stem cell and solid organ transplant recipients. Clin. Infect. Dis. 38:14281439.
17. Duthie, R.,, and D. W. Denning. 1995. Aspergillus fungemia: report of two cases and review. Clin. Infect. Dis. 20:598605.
18. Edmond, M. B.,, S. E. Wallace,, D. K. McClish,, M. A. Pfaller,, R. N. Jones, and, R. P. Wenzel. 1999. Nosocomial bloodstream infections in United States hospitals: a three-year analysis. Clin. Infect. Dis. 29:239244.
19. Guerrero, C.,, C. M. Toldos,, G. Yague,, C. Ramirez,, T. Rodriguez, and, M. Segovia. 2004. Comparison of diagnostic sensitivities of three assays (Bartels enzyme immunoassay [EIA], Biotest EIA, and Binax NOW immunochromatographic test) for detection of Legionella pneumophila serogroup 1 antigen in urine. J. Clin. Microbiol. 42:467468.
20. Hsueh, P. R.,, L. J. Teng,, S. W. Ho, and, D. T. Luh. 2003. Catheter-related sepsis due to Rhodotorula glutinis. J. Clin. Microbiol. 41:857859.
21. Isaacman, D. J.,, and R. B. Karasic. 1990. Utility of collecting blood cultures through newly inserted intravenous catheters. Pediatr. Infect. Dis. J. 9:815818.
22. Iwen, P. C.,, S. H. Hinrichs, and, M. E. Rupp. 2002. Utilization of the internal transcribed spacer regions as molecular targets to detect and identify human fungal pathogens. Med. Mycol. 40:87109.
23. Kempf, V. A.,, K. Trebesius, and, I. B. Autenrieth. 2000. Fluorescent in situ hybridization allows rapid identification of microorganisms in blood cultures. J. Clin. Microbiol. 38:830838.
24. Khoo, S. H.,, and D. W. Denning. 1994. Invasive aspergillosis in patients with AIDS. Clin. Infect. Dis. 19:S41S48.
25. Kilby, J. M.,, M. B. Marques,, D. L. Jaye,, P. B. Tabereaux,, V. B. Reddy, and, K. B. Waites. 1998. The yield of bone marrow biopsy and culture compared with blood culture in the evaluation of HIV-infected patients for mycobacterial and fungal infections. Am. J. Med. 104:123128.
26. Klastersky, J.,, S. H. Zinner,, T. Calandra,, H. Gaya,, M. P. Glauser,, F. Meunier,, M. Rossi,, S. C. Schimpff,, M. Tattersall, and, C. Viscoli. 1988. Empiric antimicrobial therapy for febrile granulocytopenic cancer patients: lessons from four EORTC trials. Eur. J. Cancer Clin. Oncol. 24:S35S45.
27. Kontoyiannis, D. P.,, H. A. Torres,, M. Chagua,, R. Hachem,, J. J. Tarrand,, G. P. Bodey, and, I. I. Raad. 2004. Trichosporonosis in a tertiary care cancer center: risk factors, changing spectrum and determinants of outcome. Scand. J. Infect. Dis. 36:564569.
28. La Scola, B.,, and D. Raoult. 1999. Culture of Bartonella quintana and Bartonella henselae from human samples: a 5-year experience (1993 to 1998). J. Clin. Microbiol. 37:18991905.
29. LeBlanc, L.,, J. Pepin,, K. Toulouse,, M. F. Ouellette,, M. A. Coulombe,, M. P. Corriveau, and, M. E. Alary. 2006. Fluoroquinolones and risk of methicillin-resistant Staphylococcus aureus, Canada. Emerg. Infect. Dis. 12:13981405.
30. MacGregor, R. R.,, and H. N. Beaty. 1972. Evaluation of positive blood cultures. Guidelines for early differentiation of contaminated from valid positive cultures. Arch. Intern. Med. 130:8487.
31. Maki, D. G.,, S. M. Stolz,, S. Wheeler, and, L. A. Mermel. 1997. Prevention of central venous catheter-related bloodstream infection by use of an antiseptic-impregnated catheter. A randomized, controlled trial. Ann. Intern. Med. 127:257266.
32. Marlowe, E. M.,, J. J. Hogan,, J. F. Hindler,, I. Andruszkiewicz,, P. Gordon, and, D. A. Bruckner. 2003. Application of an rRNA probe matrix for rapid identification of bacteria and fungi from routine blood cultures. J. Clin. Microbiol. 41:51275133.
33. Marr, K. A.,, S. A. Balajee,, L. McLaughlin,, M. Tabouret,, C. Bentsen, and, T. J. Walsh. 2004. Detection of galactomannan antigenemia by enzyme immunoassay for the diagnosis of invasive aspergillosis: variables that affect performance. J. Infect. Dis. 190:641649.
34. Marr, K. A.,, R. A. Carter,, M. Boeckh,, P. Martin, and, L. Corey. 2002. Invasive aspergillosis in allogeneic stem cell transplant recipients: changes in epidemiology and risk factors. Blood 100:43584366.
35. Marr, K. A.,, M. Laverdiere,, A. Gugel, and, W. Leisenring. 2005. Antifungal therapy decreases sensitivity of the Aspergillus galactomannan enzyme immunoassay. Clin. Infect. Dis. 40:17621769.
36. Mattei, D.,, D. Rapezzi,, N. Mordini,, F. Cuda,, C. L. Nigro,, M. Musso,, A. Arnelli,, S. Cagnassi, and, A. Gallamini. 2004. False-positive Aspergillus galactomannan enzyme-linked immunosorbent assay results in vivo during amoxicillin-clavulanic acid treatment. J. Clin. Microbiol. 42:53625363.
37. Mennink-Kersten, M. A.,, J. P. Donnelly, and, P. E. Verweij. 2004. Detection of circulating galactomannan for the diagnosis and management of invasive aspergillosis. Lancet Infect. Dis. 4:349357.
38. Mirrett, S.,, L. B. Reller,, C. A. Petti,, C. W. Woods,, B. Vazirani,, R. Sivadas, and, M. P. Weinstein. 2003. Controlled clinical comparison of BacT/ALERT standard aerobic medium with BACTEC standard aerobic medium for culturing blood. J. Clin. Microbiol. 41:23912394.
39. Nachman, S.,, O. Alpan,, R. Malowitz, and, E. D. Spitzer. 1996. Catheter-associated fungemia due to Wangiella (Exophiala) dermatitidis. J. Clin. Microbiol. 34:10111013.
40. National Committee for Clinical Laboratory Standards. 2004. Reference method for antifungal disk diffusion susceptibility testing of yeasts: approved standard M44-A. National Committee for Clinical Laboratory Standards, Wayne, PA.
41. National Committee for Clinical Laboratory Standards. 2002. Reference method for broth dilution antifungal susceptibility testing of filamentous fungi: approved standard M38-A. National Committee for Clinical Laboratory Standards, Wayne, PA.
42. National Committee for Clinical Laboratory Standards. 2002. Reference method for broth dilution antifungal susceptibility testing of yeasts: approved standard M27-A2, 2nd ed. National Committee for Clinical Laboratory Standards, Wayne, PA.
43. Nucci, M.,, and K. A. Marr. 2005. Emerging fungal diseases. Clin. Infect. Dis. 41:521526.
44. Odabasi, Z.,, G. Mattiuzzi,, E. Estey,, H. Kantarijian,, F. Saeki,, R. J. Ridge,, P. A. Ketchum,, M. A. Finkelman,, J. H. Rex, and, L. Ostrosky-Zeichner. 2004. Beta-d-glucan as a diagnostic adjunct for invasive fungal infections: validation, cutoff development, and performance in patients with acute myelogenous leukemia and myelodysplastic syndrome. Clin. Infect. Dis. 39:199205.
45. Oplustil, C. P.,, O. H. M. Leite,, M. S. Oliveira,, S. I. Sinto,, D. E. Uip,, M. Boulos, and, C. F. Mendes. 2001. Detection of mycobacteria in the bloodstream of patients with acquired immunodeficiency syndrome in a university hospital in Brazil. Braz. J. Infect. Dis. 5:252259.
46. Ostrosky-Zeichner, L.,, B. D. Alexander,, D. H. Kett,, J. Vazquez,, P. G. Pappas,, F. Saeki,, P. A. Ketchum,, J. Wingard,, R. Schiff,, H. Tamura,, M. A. Finkelman, and, J. H. Rex. 2004. Multicenter clinical evaluation of the (1,3) beta-d-glucan assay as an aid to diagnosis of fungal infections in humans. Clin. Infect. Dis. 41:654659.
47. Ostrosky-Zeichner, L.,, C. Sable,, J. Sobel,, B. D. Alexander,, G. Donowitz,, V. Kan,, C. A. Kauffman,, D. Kett, et al. 2007. Multicenter retrospective development and validation of a clinical prediction rule for nosocomial invasive candidiasis in the intensive care setting. Eur. J. Clin. Microbiol. Infect. Dis. 26:271276.
48. Pacios, E.,, L. Alcala,, M. J. Ruiz-Serrano,, D. G. de Viedma,, M. Rodriguez-Creixems,, M. Marin-Arriaza,, J. Berenguer, and, E. Bouza. 2004. Evaluation of bone marrow and blood cultures for the recovery of mycobacteria in the diagnosis of disseminated mycobacterial infections. Clin. Microbiol. Infect. 10:734737.
49. Pappas, P. G.,, J. H. Rex,, J. Lee,, R. J. Hamill,, R. A. Larsen,, W. Powderly,, C. A. Kauffman,, N. Hyslop,, J. E. Mangino,, S. Chapman,, H. W. Horowitz,, J. E. Edwards,, W. E. Dismukes, et al. 2003. A prospective observational study of candidemia: epidemiology, therapy, and influences on mortality in hospitalized adult and pediatric patients. Clin. Infect. Dis. 37:634643.
50. Peters, R. P.,, P. H. M. Savelkoul,, A. M. Simoons-Smit,, S. A. Danner,, C. M. Vandenbroucke-Grauls, and, M. A. van Agtmael. 2006. Faster identification of pathogens in positive blood cultures by fluorescence in situ hybridization in routine practice. J. Clin. Microbiol. 44:119123.
51. Peters, R. P.,, M. A. van Agtmael,, A. M. Simoons-Smit,, S. A. Danner,, C. M. Vandenbroucke-Grauls, and, P. H. Savelkoul. 2006. Rapid identification of pathogens in blood cultures with a modified fluorescence in situ hybridization assay. J. Clin. Microbiol. 44:41864188.
52. Petti, C. A.,, H. A. Bally,, M. P. Weinstein,, K. Joho,, T. Wakefield,, L. B. Reller, and, K. C. Carroll. 2006. Utility of extended blood culture incubation for isolation of Haemophilus, Actinobacillus, Cardiobacterium, Eikenella, and Kingella organisms: a retrospective multicenter evaluation. J. Clin. Microbiol. 44:257259.
53. Petti, C. A.,, A. K. Zaidi,, S. Mirrett, and, L. B. Reller. 1996. Comparison of Isolator 1.5 and BACTEC NR660 aerobic 6A blood culture systems for detection of fungemia in children. J. Clin. Microbiol. 34:18771879.
54. Pfaller, M. A.,, and D. J. Diekema. 2004. Rare and emerging opportunistic fungal pathogens: concern for resistance beyond Candida albicans and Aspergillus fumigatus. J. Clin. Microbiol. 42:44194431.
55. Pfaller, M. A.,, S. A. Messer, and, R. J. Hollis. 1995. Variations in DNA subtype, antifungal susceptibility, and slime production among clinical isolates of Candida parapsilosis. Diagn. Microbiol. Infect. Dis. 21:914.
56. Raad, I.,, W. Costerton,, U. Sabharwal,, M. Sacilowski,, E. Anaissie, and, G. P. Bodey. 1993. Ultrastructural analysis of indwelling vascular catheters: a quantitative relationship between luminal colonization and duration of placement. J. Infect. Dis. 168:400407.
57. Raad, I. I.,, and H. H. Hanna. 2002. Intravascular catheter-related infections: new horizons and recent advances. Arch. Intern. Med. 162:871878.
58. Ramos-e-Silva, M.,, and A. L. Pereira. 2005. Life-threatening eruptions due to infectious agents. Clin. Dermatol. 23:148156.
59. Ramphal, R. 2004. Changes in the etiology of bacteremia in febrile neutropenic patients and the susceptibilities of the currently isolated pathogens. Clin. Infect. Dis. 39:S25S31.
60. Reimer, L. G.,, M. L. Wilson, and, M. P. Weinstein. 1997. Update on detection of bacteremia and fungemia. Clin. Microbiol. Rev. 10:444465.
61. Rohner, P.,, B. Pepey, and, R. Auckenthaler. 1997. Advantage of combining resin with lytic BACTEC blood culture media. J. Clin. Microbiol. 35:26342638.
62. Roson, B.,, N. Fernandez-Sabe,, J. Carratala,, R. Verdaguer,, J. Dorca,, F. Manresa, and, F. Gudiol. 2004. Contribution of a urinary antigen assay (Binax NOW) to the early diagnosis of pneumococcal pneumonia. Clin. Infect. Dis. 38:222226.
63. Rothman, R. E.,, M. D. Majmudar,, G. D. Kelen,, G. Madico,, C. A. Gaydos,, T. Walker, and, T. C. Quinn. 2002. Detection of bacteremia in emergency department patients at risk for infective endocarditis using universal 16S rRNA primers in a decontaminated polymerase chain reaction assay. J. Infect. Dis. 11:16771681.
64. Safdar, N.,, and D. G. Maki. 2004. The pathogenesis of catheter-related bloodstream infection with noncuffed short-term central venous catheters. Intensive Care Med. 30:6267.
65. Sheth, N. K.,, T. R. Franson, and, P. G. Sohnle. 1985. Influence of bacterial adherence to intravascular catheters on invitro antibiotic susceptibility. Lancet ii:12661268.
66. Tan, T. Q.,, A. K. Ogeden,, J. Tillman,, G. J. Demmler, and, M. G. Rinaldi. 1992. Paecilomyces lilacinus catheter-related fungemia in an immunocompromised pediatric patient. J. Clin. Microbiol. 30:24792483.
67. Tonnesen, A.,, M. Peuler, and, W. R. Lockwood. 1976. Cultures of blood drawn by catheters versus venipuncture. JAMA 235:1877.
68. Towns, M. L.,, and L. B. Reller. 2002. Current best practices and guidelines for isolation of bacteria and fungi in infective endocarditis. Infect. Dis. Clin. N. Am. 16:363376.
69. Trick, W. E.,, S. K. Fridkin,, J. R. Edwards,, R. A. Hajjeh,, R. P. Gaynes, et al. 2002. Secular trend of hospital-acquired candidemia among intensive care unit patients in the United States during 1989–1999. Clin. Infect. Dis. 35:627630.
70. Van Scoy, R. E. 1982. Culture-negative endocarditis. Mayo Clin. Proc. 57:149154.
71. Viscoli, C.,, M. Machetti,, P. Cappellano, et al. 2004. False-positive galactomannan Platelia Aspergillus test results for patients receiving piperacillin-tazobactam. Clin. Infect. Dis. 38:913916.
72. von Gottberg, A.,, L. Sacks,, S. Machala, and, L. Blumberg. 2001. Utility of blood cultures and incidence of mycobacteremia in patients with suspected tuberculosis in a South African infectious disease referral hospital. Int. J. Tuberc. Lung Dis. 5:8086.
73. Weinstein, M. P.,, M. L. Towns,, S. M. Quartey,, S. Mirrett,, L. G. Reimer,, G. Parmigiani, and, L. B. Reller. 1997. The clinical significance of positive blood cultures in the 1990s: a prospective comprehensive evaluation of the microbiology, epidemiology, and outcome of bacteremia and fungemia in adults. Clin. Infect. Dis. 24:584602.
74. Weinstein, M. P. 2003. Blood culture contamination: persisting problems and partial progress. J. Clin. Microbiol. 41:22752278.
75. Wellinghausen, N.,, B. Wirths,, A. Essig, and, L. Wassill. 2004. Evaluation of the Hyplex BloodScreen multiplex PCR–enzyme-linked immunosorbent assay system for direct identification of gram-positive cocci and gram-negative bacilli from positive blood cultures. J. Clin. Microbiol. 42:31473152.
76. Wilson, M. L.,, T. E. Davis,, S. Mirrett,, J. Reynolds,, D. Fuller,, S. D. Allen,, K. K. Flint,, F. Koontz, and, L. B. Reller. 1993. Controlled comparison of the BACTEC high-blood-volume fungal medium, BACTEC Plus 26 aerobic blood culture bottle, and 10-milliter Isolator blood culture system for detection of fungemia and bacteremia. J. Clin. Microbiol. 31:865871.
77. Wisplinghoff, H.,, T. Bischoff,, S. M. Tallent,, H. Seifert,, R. P. Wenzel, and, M. B. Edmond. 2004. Nosocomial bloodstream infections in US hospitals: analysis of 24,179 cases from a prospective nationwide surveillance study. Clin. Infect. Dis. 39:309317.
78. Yeo, S. F.,, and B. Wong. 2002. Current status of nonculture methods for diagnosis of invasive fungal infections. Clin. Microbiol. Rev. 15:465484.

This is a required field
Please enter a valid email address
Please check the format of the address you have entered.
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error